Orthopedic Coding Alert

Question: Im trying to bill 20550 for injections of multiple sites as separate line items and bill multiple units of the drug supply, and all but one of the injections gets denied. What am I doing wrong?

Louisiana Subscriber 
  
Answer: If the multiple injections take place at different sites, appending modifier -59 (distinct procedural service) to the second, third, etc., injection code should get reimbursed. Most carriers will pay for only a single injection when multiple injections are given at the same anatomic site, and some will reimburse for only one injection as an across-the-board policy. Check with your carrier for its policy on multiple injections.
 
You should be reimbursed for the drug. When you are injecting multiple fingers or toes and your carrier accepts HCPCS Level II modifiers, append modifiers FA-F9 (fingers) or TA-T9 (toes) to the injection codes; these modifiers are location-specific and should alleviate the confusion. Submit this as a single line using the appropriate J code and indicate the total number of units dispensed.
-- Answers to You Be the Coder and Reader Questions provided by Heidi Stout, CPC, CCS-P, coding and reimbursement manager at University Orthopedic Associates in New Brunswick, N.J.